HomeMy WebLinkAbout10-6172Form 668 MW
(Rev. February 2004)
3621
Department of the Treasury - Internal Revenue Service
Notice of Federal Tax Lien
Area: Serial Number
SMALL BUSINESS/SELF EMPLOYED AREA #2
Lien Unit Phone: (800) 829-3903 701435510
As provided by section 6321, 6322, and 6323 of the internal Revenue
Code, we are giving a notice that taxes (including interest and penalties)
have been assessed against the following-named taxpayer. We have made
a demand for payment of this liability, but it remains unpaid. Therefore,
there is a lien in favor of the United States on all property and rights to
property belonging to this taxpayer for the amount of these taxes, and
additional penalties, interest, and costs that may accrue.
Name of Taxpayer HARRY J
Residence 98 HERMAN AVE APT B
LEMOYNE, PA 17043-1974
IMPORTANT RELEASE INFORMATION: For each assessment listed below,
unless notice of the lien is refiled by the date given in column (e), this notice shall,
on the day following such date, operate as a certificate of release as defined
in IRC 6325(a).
For Optional Use by Recording Office
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Tax Period Date of Last Day for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refihng of Assessment
(a) (b) (c) (d) (e) (f)
1040 12/31/2007 XXX-XX-4374 06/02/2008 07/02/2018 2309.43
1040 12/31/2008 XXX-XX-4374 07/27/2009 08/26/2019 4519.18
Place of Filing
Prothonotary
Cumberland County
Carlisle,. PA 17013
Total 1 $ 6828.61
This notice was prepared and signed at
the 17th day of September
DETROIT, MI
2010
, on this,
Signature
??. fi, ) Title
ACS 22-00-0008
for MICHAEL W. COX (800) 829-3903
(NOTE: Certificate of officer authorized by law to take acknowledgment is not essential to the validity of Notice of Federal Tax lien
Rev. Rul. 71-466, 1971 - 2 C.B. 409) Form 668(Y)(c) (Rev. 2-2004)
Part I - Kept By Recording Office CAT. NO 60025X